clinician perspectives on the need for training and caring for pregnant women with intellectual and developmental disabilities

• DOI: 10.13028/pw8b-ya25
• Publication Date: 2022-04-01
• Authors: Amir, Nili; Smith, Lauren; Valentine, Anne M.; Mitra, Monika; Parish, Susan L.; Moore Simas, Tiffany
• Keywords: Medical education; Developmental Disabilities; Health Personnel; Intellectual disability; 331; Graduate medical education; 03 medical and health sciences; Maternal and Child Health; 0302 clinical medicine; Pregnancy; Training; Humans; Disabled Persons; Child; Disability Studies; Qualitative Research; Pregnancy Outcome; Obstetrics and Gynecology; 16. Peace & justice; 3. Good health; Obstetrics; Women's Health; Female; Pregnant Women; Female Urogenital Diseases and Pregnancy Complications

Background: Women with intellectual and developmental disabilities (IDD) experience disparities in obstetric care access and quality, in addition to communication gaps with healthcare providers. Many obstetric providers are untrained and uneducated about critical aspects of providing care to persons with IDD. Objectives: The present study was conducted (1) to describe obstetric clinicians’ training experiences related to providing obstetric care to women with IDD, (2) to assess obstetric clinicians’ perceived need for formalized training, and (3) to identify recommendations for training content and dissemination. Methods: This study involved qualitative individual interviews (n=9) and one focus group (n=8) with obstetric clinicians who self-reported experience caring for women with IDD during pregnancy. Descriptive coding and content analysis techniques were used to develop an iterative codebook related to education and training; codes were applied to the data. Coded data were analyzed for larger themes and relationships. Results: Analysis revealed three main themes: 1. Need for obstetric training and education: No participant reported receiving any training in caring for pregnant women with IDD. Participants expressed a need for formal education. 2. Recommendations for formal training: Participants noted a dearth of clinical practice guidelines, the need for pregnancy-specific training during residency and beyond, and all healthcare staff should be included in training opportunities. 3. Training outcomes should increase knowledge, enhance attitudes, and develop practical skills related to communication and care for pregnant women with IDD. Conclusion: Study results indicate a need for and interest in systematic training efforts regarding obstetric care for women with IDD. Improved training and education may decrease health inequities and improve the quality of obstetric care, and thus pregnancy outcomes, for women with IDD.